05060134 CITY OF CUPERTINO 'oSwc; «� i
BUILDING DIVISION PERMITCONTRACTOR INFORMATION
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BUILDING ADDRESS: DONE RIGHT INC PERMITNo05060134
OWNER'S NAME: PERMIT ISSUE DATE
ALAN PETER
NE: SANITARY NO. CONTROL NO.
(408) 377-8777
ARCHITEC t`ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
_oo LICENSED CONTRACTOR'S DECLARATION
e C I hereby affirm Nu 1 am licensed under provisions of Chapter 9(commencing Job Description
tomwlNScctian?W0)af Div'ion3 file Buri. and Prof. odex,imyliccnxis
rat ren roma Ana rcnct. �, (p REROOF W/SHINGLES
p q g Liccnx CI a Lie.• - '
=� Date Conxecxr
ARCHll m and DELLA recoATION
I undcrsmnJ my plans shell he d az public rds
saes
o� Licensed Pmfessi...I
S OWNER-BUILDER DECLARATION
1 hereby affirm On,1.m exempt fru.the Cmami Liccnx Lew for be
EO following mason.(Sccuun Trn 1.5.Business and Pmferainm Code:Any city or county
K m to which acquires a Permit cal construct.filler.Emporia,demolish.or repair any atNLW m19134
y—rn prior m its issuance.Alan rePermit
quires the applicant for such peit to file A signed statement
` ' Nm he is licensedpursuanuuthcprovisiauoftheCanuxctuhLiceaxlaw(ChaP¢r9 Sq.Ft.Floor Area Valuation
zHEer (commencing with Section 7")of Division 3 of the Business and Profassiam Code)or
a $ Nat he is exempt thexf.m and the bun for de alleged exemption.Any violation of
Section 7031.5 by any applicantfor a permit subjects the applicant o a civil Penalty of 3C 9]3'QIt�{ber00 Occupancy Type
not mom Nan five hundred doll..(SSM).
❑I.its owner of the profeary.or my employees with wages as their sole Compensation,
will do the wart,and he swetux is not intended or offered for sale(Sec.7044,Bmimm
and Profavi.ts Cade:The Cmnt.cml4 License Law dean not apply to an owner of Required Inspections
propery who builditmurtrove,Nemooand who dacaanch woichimeelfor through his _
awn cmployua,provided Nat such improvements ax not intended oroffered far In.If.
however,the building or improvement is sold within arc year of compleuan,the owner.
builder will mote the,burden or proving that be did not build or improve for propose of
rale.).
I,.owner of the prapcny,am exclusively Concocting with licensed Contractors to
consumer the pmject(Sec.7014.Business and Professions Code:)The Comracmh Li.
,cue law don not apply to an owner of property who builds or improves thereon,and a�
who coronets for such projects with a contn.or(s)licensed pursuant in the Cenvactofs p
Law.
0 1..
!/II ppp
I exempt under Sec. .B&P C for this xazan
Owner
Dox C
WORKER'S COMPENSATION DECLARATION
I hereby affirm under Penalty of perjury one of Ne following declarations:
737 l hs ere and will maintain a Certificate of Cement to relfinsux for Wornces Compo.ion,az provided for by SCelfian 37W of Ute labor Code,for the performance of therk far which Nis permit is issued.I nave and will maintain Wmkcfa Com.of the w lkfrance, h rt,Exor by Sssu d.W of Ne labor Code.far Ne-pcnformarme of the work for which Nis permit isissud.y Workefs mm�s+raimi ¢rann. carivandPolicynmbermaMer.l L�v�[J Policy
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(Thu cocoon bond not ba completed if be Permit la forum,hundred dollars(SIM)
or ices.)
I unify that in Uc performance of the work for which this Permit is issued,1 aha11 not
employ any person in any manna.as m bueme subject m tie Wmical Competition
laws of Califon..Date
Applicant
NOTICE TO APPLICANT:If.after making this Certificate of Exemption.you should
become subject to Ne Worker's Compensation previsions of the Labor Code.you must
.JO forthwith comply with such provisions or this Permit shall be deemed revoked.
'�"" CONSTRUCTION LENDING AGENCY
I hereby affirm that Nero is a Construction lending agency for the performance of
a 7 Ne work fur which this permit I.issued(Sec.3(y97.Civ.C.) _
f[]0 lender's Name
= Z Lender's Address
L)O 1 certify that I have rad this application and sum that the about information is '
(L F correct.I agree to comply with all city and county ordinances and sm¢laws relating to
�U building commuction,and hereby auNoria,representatives of this city in cher upon the
G above-mentioned property for inspection purposes.
(We-)agree or save,indemnify and keep harnleu the City of Cupcnmo against
F" V1 liabilities,judgments,costs and expenses which may in any way accme against mid City
U Z in constitution of the grant this Permit.
APPLICANT U ERS - AND WILL COMPLY WITH ALL NOJJJ444 POINT Issued by: Date
SOURCE
Re-roofs
Sig UA44carluccommeso, Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Be applicant or future building occupant stem or handle havudous material
az defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
de,Sem mon 25532(a)? / All roofs shall be inspected prior to any roofing material being installed.
❑Yes �O
Will the applicant or future building mupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
go
it harallouc sir ecal .,bane u Jefnpd by the Bay Arca Air Quality Management all new materials for inspection.
imdn? .Yrs.J/
Yes
1 have read the hammous materials requirements under Chapter695 ofd¢Califon
.is Health&Safety Code,Seem.25505,25533 and 25534.1 understand hatifthe building
does no' y h a meant,that it is my mmonsibility to nnuly Ne-meupent of the
mgr, tmmet poor toisneaceof.CcnifieamofDa cy. Signature of Applicant Date
��/�
QN' rorinumm.dagcnt Date All roof coverings to be Class "B" or better
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
Building De artment
JOB ADDRESS: h53 a f0�� n� PERMIT#
u o O 3 �
OWNER'S NAME: PHONE #
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors: � w
Signature Date
Please check applicable subcontractors and complete the followinginformation:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
er/Contractor Signature Date
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
I Telephone: (408) 777-3228
CITY OF
U P E f�T I N 0 Fax: (408) 777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed, a plywood nail inspection is required.
® 6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: //_�/
lob Site Address: /OS f36 /fC RpJ Az_
Roofing Company Name: 1Jj�
Applicant's Signature: Date:��US
eGreg Cast eel
Building Official
Revised 11/2/04
Printed on Recycled Paper
CITY OF CUPERTINO
REROOF
cuPErJJINO PERMIT APPLICATION FORM
APN W3 DL�-1 Date:
Building Address: _ ��f �2
Owner's Name: Phone#:
Contractor: Phone#: 27� 777 License#: ��
/Jf J G C z Cr,
Contact: Phone#- Cupertino Business License #:
Pil/1/ C
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ It-Up roof
❑ 4sphalt Shingles Asphalt Shingles
end Shakes ❑ Wood Shakes
Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfg.Installation Specs,
I Have Read, Underst d and Will Comply With Cu ertino's Tear Off Policy:
Job Description: 71—p j ! ' 30p �G c,,'e�+-
Residential Commercial ❑ l
Fire Zone: Yes ❑ No ❑ Confirmed with Planning De t. if
there are any restrictions: LJ
Cost of Project / t /�// Type of Construction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
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